Jw Ruby Memorial Hospital Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Jw Ruby Memorial Hospital, Morgantown, WV in 2024, from traditional Medicare claims. Back to the Jw Ruby Memorial Hospital profile, with quality ratings, finances and negotiated rates.
5,907
Medicare inpatient discharges
In 180 published DRGs
2.35
Case mix index
IPPS FY 2027
36%
Surgical stays
66%
Stays with complications
In DRGs with a CC or MCC
6,323
Medicare outpatient services
In 56 service groups
Inpatient stays by major diagnostic category
Circulatory system1,427 discharges in 40 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 220 | $46,212 | $9,582 | $12,523 | 1.28 |
| Endovascular cardiac valve replacement and supplement procedures without MCCMS-DRG 267, surgical | 97 | $124,668 | $35,241 | $33,785 | 4.88 |
| Percutaneous and other intracardiac procedures without MCCMS-DRG 274, surgical | 84 | $76,150 | $23,295 | $20,637 | 3.24 |
| Acute myocardial infarction, discharged alive with MCCMS-DRG 280, medical | 71 | $68,492 | $11,841 | $18,561 | 1.59 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 66 | $28,321 | $4,863 | $7,675 | 0.74 |
| Syncope and collapseMS-DRG 312, medical | 60 | $29,669 | $5,768 | $8,040 | 0.86 |
| Other circulatory system diagnoses with MCCMS-DRG 314, medical | 46 | $61,744 | $14,478 | $16,733 | 2.09 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 219, surgical | 44 | $334,366 | $64,550 | $90,613 | 7.71 |
| Coronary bypass without cardiac catheterization without MCCMS-DRG 236, surgical | 42 | $185,242 | $24,292 | $50,200 | 4.04 |
| Percutaneous cardiovascular procedures with intraluminal device without MCCMS-DRG 322, surgical | 38 | $89,132 | $11,684 | $24,155 | 1.82 |
| Hypertension without MCCMS-DRG 305, medical | 37 | $28,341 | $4,483 | $7,681 | 0.75 |
| Other major cardiovascular procedures with MCCMS-DRG 270, surgical | 36 | $234,127 | $42,592 | $63,448 | 5.06 |
| Acute myocardial infarction, discharged alive with CCMS-DRG 281, medical | 35 | $41,725 | $6,315 | $11,308 | 0.91 |
| Cardiac arrhythmia and conduction disorders with MCCMS-DRG 308, medical | 35 | $47,290 | $8,284 | $12,816 | 1.20 |
| Cardiac arrhythmia and conduction disorders without cc/mccMS-DRG 310, medical | 35 | $18,962 | $3,086 | $5,139 | 0.55 |
| Cardiac valve and other major cardiothoracic procedures without cardiac catheterizationMS-DRG 220, surgical | 32 | $212,748 | $36,088 | $57,655 | 5.24 |
| Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/MS-DRG 321, surgical | 32 | $120,444 | $20,507 | $32,640 | 2.87 |
| Coronary bypass without cardiac catheterization with MCCMS-DRG 235, surgical | 30 | $238,516 | $37,965 | $64,638 | 5.88 |
| Other vascular procedures with MCCMS-DRG 252, surgical | 29 | $129,980 | $24,471 | $35,224 | 3.35 |
| Circulatory disorders except AMI, with cardiac catheterization with MCCMS-DRG 286, medical | 28 | $80,104 | $15,337 | $21,708 | 2.16 |
| Permanent cardiac pacemaker implant with CCMS-DRG 243, surgical | 25 | $71,544 | $16,947 | $19,388 | 2.28 |
| Other vascular procedures with CCMS-DRG 253, surgical | 25 | $101,250 | $17,573 | $27,439 | 2.55 |
| Peripheral vascular disorders with CCMS-DRG 300, medical | 24 | $49,868 | $7,001 | $13,514 | 1.07 |
| Other circulatory system diagnoses with CCMS-DRG 315, medical | 21 | $39,598 | $7,113 | $10,731 | 0.97 |
| Aortic and heart assist procedures except pulsation balloon without MCCMS-DRG 269, surgical | 18 | $130,077 | $25,519 | $35,251 | 4.16 |
| Permanent cardiac pacemaker implant with MCCMS-DRG 242, surgical | 17 | $123,719 | $24,762 | $33,528 | 3.46 |
| Endovascular cardiac valve replacement and supplement procedures with MCCMS-DRG 266, surgical | 17 | $163,125 | $47,446 | $44,207 | 6.25 |
| Chest painMS-DRG 313, medical | 17 | $32,628 | $4,747 | $8,842 | 0.72 |
| Other cardiothoracic procedures with MCCMS-DRG 228, surgical | 16 | $144,588 | $38,725 | $39,183 | 5.04 |
| Acute myocardial infarction, expired with MCCMS-DRG 283, medical | 16 | $89,603 | $15,519 | $24,282 | 1.97 |
| Atherosclerosis without MCCMS-DRG 303, medical | 16 | $21,583 | $3,863 | $5,849 | 0.66 |
| Percutaneous and other intracardiac procedures with MCCMS-DRG 273, surgical | 15 | $161,208 | $31,316 | $43,687 | 3.90 |
| Cardiac valve and other major cardiothoracic procedures with cardiac catheterization witMS-DRG 216, surgical | 14 | $333,625 | $72,758 | $90,412 | 9.71 |
| Other cardiothoracic procedures without MCCMS-DRG 229, surgical | 14 | $115,319 | $25,484 | $31,251 | 3.18 |
| Other circulatory system o.r. proceduresMS-DRG 264, surgical | 14 | $103,808 | $21,542 | $28,132 | 3.27 |
| Circulatory disorders except AMI, with cardiac catheterization without MCCMS-DRG 287, medical | 14 | $66,282 | $6,914 | $17,962 | 1.08 |
| Other major cardiovascular procedures with CCMS-DRG 271, surgical | 13 | $158,455 | $24,346 | $42,941 | 3.46 |
| Coronary bypass with cardiac catheterization or open ablation with MCCMS-DRG 233, surgical | 12 | $307,150 | $66,709 | $83,238 | 7.80 |
| Peripheral vascular disorders with MCCMS-DRG 299, medical | 11 | $78,140 | $16,365 | $21,176 | 1.58 |
| Other endovascular cardiac valve procedures with MCCMS-DRG 319, surgical | 11 | $201,596 | $37,582 | $54,632 | 4.36 |
Nervous system773 discharges in 27 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Intracranial hemorrhage or cerebral infarction with MCCMS-DRG 064, medical | 100 | $82,761 | $14,478 | $22,428 | 2.00 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 82 | $44,084 | $6,707 | $11,947 | 1.02 |
| Craniotomy and endovascular intracranial procedures with MCCMS-DRG 025, surgical | 76 | $161,661 | $31,207 | $43,810 | 4.42 |
| Seizures without MCCMS-DRG 101, medical | 48 | $25,946 | $5,752 | $7,031 | 0.91 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis with MCC oMS-DRG 023, surgical | 43 | $186,365 | $41,256 | $50,505 | 5.67 |
| Craniotomy and endovascular intracranial procedures without cc/mccMS-DRG 027, surgical | 36 | $84,666 | $16,932 | $22,945 | 2.43 |
| Seizures with MCCMS-DRG 100, medical | 34 | $83,130 | $13,988 | $22,528 | 1.98 |
| Degenerative nervous system disorders without MCCMS-DRG 057, medical | 28 | $41,356 | $8,331 | $11,207 | 1.36 |
| Craniotomy and endovascular intracranial procedures with CCMS-DRG 026, surgical | 26 | $108,745 | $20,566 | $29,470 | 2.95 |
| Cranial and peripheral nerve disorders without MCCMS-DRG 074, medical | 26 | $32,056 | $5,878 | $8,687 | 1.03 |
| Traumatic stupor and coma >1 hour with MCCMS-DRG 082, medical | 23 | $82,534 | $17,041 | $22,367 | 2.28 |
| Other disorders of nervous system with CCMS-DRG 092, medical | 21 | $28,648 | $7,012 | $7,764 | 1.03 |
| Intracranial hemorrhage or cerebral infarction without cc/mccMS-DRG 066, medical | 19 | $35,585 | $4,300 | $9,644 | 0.69 |
| Other cerebrovascular disorders with CCMS-DRG 071, medical | 18 | $50,148 | $7,750 | $13,590 | 1.06 |
| Traumatic stupor and coma <1 hour with CCMS-DRG 086, medical | 18 | $40,046 | $9,259 | $10,852 | 1.32 |
| Headaches without MCCMS-DRG 103, medical | 18 | $23,413 | $5,258 | $6,345 | 0.84 |
| Carotid artery stent procedures with CCMS-DRG 035, surgical | 17 | $106,349 | $16,301 | $28,821 | 2.30 |
| Carotid artery stent procedures without cc/mccMS-DRG 036, surgical | 17 | $65,700 | $12,264 | $17,805 | 1.81 |
| Nervous system neoplasms with MCCMS-DRG 054, medical | 16 | $54,192 | $10,457 | $14,686 | 1.47 |
| Intracranial vascular procedures with principal diagnosis hemorrhage with MCCMS-DRG 020, surgical | 15 | $185,097 | $68,118 | $50,161 | 8.45 |
| Degenerative nervous system disorders with MCCMS-DRG 056, medical | 15 | $86,672 | $14,119 | $23,488 | 2.39 |
| Traumatic stupor and coma >1 hour with CCMS-DRG 083, medical | 15 | $46,129 | $9,197 | $12,501 | 1.36 |
| Traumatic stupor and coma <1 hour without cc/mccMS-DRG 087, medical | 14 | $27,270 | $5,525 | $7,390 | 0.89 |
| Other cerebrovascular disorders with MCCMS-DRG 070, medical | 13 | $72,192 | $11,959 | $19,564 | 1.79 |
| Craniotomy with major device implant or acute complex CNS principal diagnosis without mcMS-DRG 024, surgical | 12 | $138,171 | $26,177 | $37,444 | 3.79 |
| Traumatic stupor and coma <1 hour with MCCMS-DRG 085, medical | 12 | $61,286 | $16,945 | $16,608 | 2.27 |
| Peripheral, cranial nerve and other nervous system procedures without cc/mccMS-DRG 042, surgical | 11 | $69,106 | $10,869 | $18,728 | 1.74 |
Infectious and parasitic diseases615 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Septicemia or severe sepsis without MV >96 hours with MCCMS-DRG 871, medical | 383 | $79,355 | $14,706 | $21,505 | 1.98 |
| Infectious and parasitic diseases with o.r. procedures with MCCMS-DRG 853, surgical | 109 | $158,016 | $36,150 | $42,822 | 5.00 |
| Septicemia or severe sepsis without MV >96 hours without MCCMS-DRG 872, medical | 63 | $36,622 | $6,742 | $9,924 | 1.03 |
| Septicemia or severe sepsis with MV >96 hoursMS-DRG 870, medical | 18 | $277,398 | $45,046 | $75,175 | 6.96 |
| Infectious and parasitic diseases with o.r. procedures with CCMS-DRG 854, surgical | 17 | $67,728 | $14,237 | $18,354 | 2.04 |
| Postoperative or post-traumatic infections with o.r. procedures with CCMS-DRG 857, surgical | 14 | $82,302 | $16,462 | $22,304 | 2.14 |
| Postoperative or post-traumatic infections with o.r. procedures with MCCMS-DRG 856, surgical | 11 | $145,141 | $32,507 | $39,333 | 4.43 |
Musculoskeletal system and connective tissue613 discharges in 20 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 106 | $74,465 | $12,903 | $20,180 | 1.88 |
| Medical back problems without MCCMS-DRG 552, medical | 64 | $32,063 | $6,251 | $8,689 | 0.97 |
| Hip and femur procedures except major joint with CCMS-DRG 481, surgical | 60 | $82,108 | $13,930 | $22,251 | 2.07 |
| Revision of hip or knee replacement with CCMS-DRG 467, surgical | 50 | $146,024 | $24,046 | $39,573 | 3.49 |
| Cervical spinal fusion with CCMS-DRG 472, surgical | 35 | $140,410 | $19,851 | $38,051 | 2.96 |
| Spinal fusion except cervical without MCCMS-DRG 460, surgical | 32 | $161,773 | $22,631 | $43,840 | 3.66 |
| Hip and femur procedures except major joint with MCCMS-DRG 480, surgical | 32 | $136,799 | $22,228 | $37,072 | 2.95 |
| Lower extremity and humerus procedures except hip, foot and femur with CCMS-DRG 493, surgical | 24 | $71,873 | $17,143 | $19,478 | 2.40 |
| Medical back problems with MCCMS-DRG 551, medical | 24 | $46,996 | $11,961 | $12,736 | 1.70 |
| Hip replacement with principal diagnosis of hip fracture without MCCMS-DRG 522, surgical | 23 | $100,216 | $14,695 | $27,159 | 2.11 |
| Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCMS-DRG 563, medical | 23 | $29,096 | $5,343 | $7,885 | 0.90 |
| Other musculoskeletal system and connective tissue o.r. procedures with CCMS-DRG 516, surgical | 22 | $94,668 | $14,783 | $25,655 | 2.04 |
| Wound debridement and skin graft except hand for musculoskeletal and connective tissue dMS-DRG 464, surgical | 18 | $118,357 | $18,841 | $32,075 | 3.00 |
| Back and neck procedures except spinal fusion with CCMS-DRG 519, surgical | 17 | $96,393 | $12,132 | $26,122 | 1.97 |
| Hip replacement with principal diagnosis of hip fracture with MCCMS-DRG 521, surgical | 17 | $139,278 | $23,313 | $37,744 | 2.99 |
| Revision of hip or knee replacement with MCCMS-DRG 466, surgical | 16 | $194,192 | $36,435 | $52,626 | 5.19 |
| Pathological fractures and musculoskeletal and connective tissue malignancy with CCMS-DRG 543, medical | 15 | $41,057 | $7,618 | $11,127 | 1.09 |
| Major joint or limb reattachment procedures of upper extremitiesMS-DRG 483, surgical | 13 | $83,356 | $15,583 | $22,589 | 2.48 |
| Combined anterior and posterior spinal fusion without cc/mccMS-DRG 455, surgical | 11 | $148,177 | $30,826 | $40,156 | 4.61 |
| Lower extremity and humerus procedures except hip, foot and femur without cc/mccMS-DRG 494, surgical | 11 | $58,300 | $12,414 | $15,799 | 1.87 |
Respiratory system605 discharges in 15 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 109 | $49,212 | $8,526 | $13,336 | 1.23 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 90 | $50,354 | $8,493 | $13,646 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 84 | $58,144 | $11,453 | $15,757 | 1.70 |
| Pulmonary embolism with MCC or acute cor pulmonaleMS-DRG 175, medical | 40 | $46,234 | $10,230 | $12,529 | 1.40 |
| Respiratory system diagnosis with ventilator support <=96 hoursMS-DRG 208, medical | 39 | $104,407 | $19,213 | $28,294 | 2.70 |
| Major chest procedures with CCMS-DRG 164, surgical | 38 | $93,527 | $16,951 | $25,346 | 2.55 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 37 | $46,353 | $7,888 | $12,562 | 1.10 |
| Major chest procedures with MCCMS-DRG 163, surgical | 33 | $148,104 | $36,833 | $40,136 | 4.71 |
| Major chest trauma with CCMS-DRG 184, medical | 27 | $45,436 | $6,798 | $12,313 | 1.05 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 22 | $28,655 | $5,467 | $7,766 | 0.82 |
| Pulmonary embolism without MCCMS-DRG 176, medical | 21 | $32,207 | $5,013 | $8,728 | 0.82 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 20 | $37,623 | $6,629 | $10,196 | 0.99 |
| Other respiratory system o.r. procedures with MCCMS-DRG 166, surgical | 16 | $117,497 | $32,028 | $31,842 | 4.06 |
| Respiratory system diagnosis with ventilator support >96 hoursMS-DRG 207, medical | 15 | $209,990 | $41,923 | $56,907 | 6.91 |
| Major chest procedures without cc/mccMS-DRG 165, surgical | 14 | $82,640 | $11,710 | $22,396 | 1.88 |
Digestive system537 discharges in 17 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 73 | $23,737 | $5,103 | $6,433 | 0.79 |
| Major small and large bowel procedures with CCMS-DRG 330, surgical | 68 | $128,763 | $16,269 | $34,895 | 2.37 |
| Gastrointestinal hemorrhage with MCCMS-DRG 377, medical | 49 | $59,908 | $13,177 | $16,235 | 1.79 |
| Gastrointestinal hemorrhage with CCMS-DRG 378, medical | 48 | $32,444 | $6,573 | $8,792 | 0.98 |
| Major small and large bowel procedures with MCCMS-DRG 329, surgical | 41 | $193,841 | $34,481 | $52,531 | 4.52 |
| Other digestive system diagnoses with CCMS-DRG 394, medical | 37 | $33,390 | $5,816 | $9,049 | 0.94 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCMS-DRG 391, medical | 36 | $32,302 | $8,491 | $8,754 | 1.28 |
| Gastrointestinal obstruction with CCMS-DRG 389, medical | 33 | $25,739 | $5,007 | $6,975 | 0.80 |
| Major small and large bowel procedures without cc/mccMS-DRG 331, surgical | 24 | $118,596 | $10,094 | $32,139 | 1.67 |
| Other digestive system diagnoses with MCCMS-DRG 393, medical | 24 | $69,020 | $13,547 | $18,704 | 1.62 |
| Other digestive system o.r. procedures with MCCMS-DRG 356, surgical | 19 | $167,843 | $37,566 | $45,485 | 4.28 |
| Gastrointestinal obstruction without cc/mccMS-DRG 390, medical | 19 | $19,626 | $2,835 | $5,319 | 0.56 |
| Stomach, esophageal and duodenal procedures with CCMS-DRG 327, surgical | 17 | $105,125 | $20,054 | $28,489 | 2.50 |
| Stomach, esophageal and duodenal procedures without cc/mccMS-DRG 328, surgical | 14 | $97,028 | $10,183 | $26,295 | 1.60 |
| Digestive malignancy with CCMS-DRG 375, medical | 12 | $48,550 | $7,440 | $13,157 | 1.20 |
| Other digestive system diagnoses without cc/mccMS-DRG 395, medical | 12 | $20,715 | $3,644 | $5,614 | 0.65 |
| Stomach, esophageal and duodenal procedures with MCCMS-DRG 326, surgical | 11 | $188,361 | $37,583 | $51,046 | 5.08 |
Kidney and urinary tract451 discharges in 11 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Renal failure with MCCMS-DRG 682, medical | 74 | $59,055 | $11,275 | $16,004 | 1.50 |
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 71 | $24,443 | $5,048 | $6,624 | 0.81 |
| Renal failure with CCMS-DRG 683, medical | 68 | $30,039 | $6,058 | $8,141 | 0.90 |
| Other kidney and urinary tract diagnoses with MCCMS-DRG 698, medical | 67 | $56,515 | $11,251 | $15,315 | 1.65 |
| Kidney and urinary tract infections with MCCMS-DRG 689, medical | 52 | $35,798 | $8,390 | $9,701 | 1.17 |
| Other kidney and urinary tract diagnoses with CCMS-DRG 699, medical | 33 | $30,570 | $7,158 | $8,284 | 1.02 |
| Kidney and ureter procedures for non-neoplasm without cc/mccMS-DRG 661, surgical | 21 | $56,398 | $7,161 | $15,284 | 1.05 |
| Kidney and ureter procedures for non-neoplasm with MCCMS-DRG 659, surgical | 20 | $71,705 | $15,810 | $19,432 | 2.59 |
| Kidney and ureter procedures for non-neoplasm with CCMS-DRG 660, surgical | 20 | $44,435 | $9,262 | $12,042 | 1.35 |
| Other kidney and urinary tract procedures with MCCMS-DRG 673, surgical | 13 | $160,783 | $29,776 | $43,572 | 3.70 |
| Kidney and ureter procedures for neoplasm without cc/mccMS-DRG 658, surgical | 12 | $100,237 | $7,241 | $27,164 | 1.48 |
Endocrine, nutritional and metabolic212 discharges in 7 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCMS-DRG 641, medical | 63 | $24,120 | $5,296 | $6,537 | 0.78 |
| Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCMS-DRG 640, medical | 54 | $48,100 | $9,770 | $13,035 | 1.32 |
| Diabetes with CCMS-DRG 638, medical | 30 | $31,510 | $6,258 | $8,539 | 0.90 |
| O.r. procedures for obesity without cc/mccMS-DRG 621, surgical | 17 | $84,888 | $8,029 | $23,005 | 1.52 |
| Diabetes with MCCMS-DRG 637, medical | 16 | $56,427 | $8,850 | $15,292 | 1.45 |
| Endocrine disorders with MCCMS-DRG 643, medical | 16 | $36,792 | $10,137 | $9,971 | 1.65 |
| Endocrine disorders with CCMS-DRG 644, medical | 16 | $35,939 | $7,025 | $9,740 | 1.06 |
Liver, gallbladder and pancreas164 discharges in 9 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Disorders of the biliary tract with MCCMS-DRG 444, medical | 30 | $60,338 | $12,151 | $16,352 | 1.63 |
| Disorders of the biliary tract with CCMS-DRG 445, medical | 30 | $36,463 | $6,930 | $9,882 | 1.09 |
| Malignancy of hepatobiliary system or pancreas with MCCMS-DRG 435, medical | 22 | $53,796 | $12,590 | $14,579 | 1.76 |
| Cirrhosis and alcoholic hepatitis with MCCMS-DRG 432, medical | 18 | $57,397 | $11,883 | $15,555 | 1.92 |
| Pancreas, liver and shunt procedures with CCMS-DRG 406, surgical | 16 | $140,199 | $19,947 | $37,994 | 2.89 |
| Disorders of pancreas except malignancy with CCMS-DRG 439, medical | 14 | $25,820 | $5,882 | $6,997 | 0.86 |
| Disorders of the biliary tract without cc/mccMS-DRG 446, medical | 12 | $26,612 | $4,563 | $7,212 | 0.80 |
| Laparoscopic cholecystectomy without C.D.E. with CCMS-DRG 418, surgical | 11 | $83,072 | $11,803 | $22,512 | 1.63 |
| Cirrhosis and alcoholic hepatitis with CCMS-DRG 433, medical | 11 | $41,974 | $7,421 | $11,375 | 1.03 |
Injuries, poisonings and toxic effects of drugs86 discharges in 5 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Complications of treatment with CCMS-DRG 920, medical | 24 | $34,188 | $6,937 | $9,265 | 1.03 |
| Poisoning and toxic effects of drugs with MCCMS-DRG 917, medical | 19 | $63,339 | $10,498 | $17,165 | 1.60 |
| Complications of treatment with MCCMS-DRG 919, medical | 16 | $86,823 | $14,186 | $23,529 | 1.82 |
| Other o.r. procedures for injuries with MCCMS-DRG 907, surgical | 14 | $145,991 | $23,636 | $39,564 | 3.72 |
| Other o.r. procedures for injuries with CCMS-DRG 908, surgical | 13 | $59,001 | $13,407 | $15,989 | 2.00 |
Skin, subcutaneous tissue and breast78 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 52 | $24,717 | $5,922 | $6,698 | 0.88 |
| Trauma to the skin, subcutaneous tissue and breast without MCCMS-DRG 605, medical | 14 | $27,904 | $5,778 | $7,562 | 0.91 |
| Cellulitis with MCCMS-DRG 602, medical | 12 | $69,596 | $10,534 | $18,860 | 1.49 |
Blood and immune system63 discharges in 4 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Red blood cell disorders without MCCMS-DRG 812, medical | 21 | $32,200 | $5,789 | $8,726 | 0.90 |
| Red blood cell disorders with MCCMS-DRG 811, medical | 19 | $46,479 | $10,058 | $12,596 | 1.40 |
| Coagulation disordersMS-DRG 813, medical | 12 | $62,898 | $11,560 | $17,045 | 1.56 |
| Major hematological and immunological diagnoses except sickle cell crisis and coagulatioMS-DRG 809, medical | 11 | $39,021 | $8,533 | $10,575 | 1.20 |
Transplants, ECMO and tracheostomy (pre-MDC)50 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| ECMO or tracheostomy with MV >96 hours or principal diagnosis except face, mouth and necMS-DRG 003, surgical | 29 | $670,676 | $158,354 | $181,753 | 21.32 |
| Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck withouMS-DRG 004, surgical | 21 | $341,881 | $76,306 | $92,650 | 14.70 |
Blood cancers and poorly differentiated neoplasms50 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Chemotherapy without acute leukemia as secondary diagnosis with CCMS-DRG 847, medical | 18 | $53,481 | $13,892 | $14,493 | 1.21 |
| Lymphoma and non-acute leukemia with MCCMS-DRG 840, medical | 17 | $89,504 | $24,359 | $24,256 | 3.13 |
| Lymphoma and non-acute leukemia with CCMS-DRG 841, medical | 15 | $83,566 | $11,127 | $22,646 | 1.57 |
Other47 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Extensive o.r. procedures unrelated to principal diagnosis with MCCMS-DRG 981, surgical | 31 | $165,953 | $37,585 | $44,973 | 4.74 |
| Extensive o.r. procedures unrelated to principal diagnosis with CCMS-DRG 982, surgical | 16 | $105,353 | $19,057 | $28,551 | 2.49 |
Factors influencing health status46 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Signs and symptoms without MCCMS-DRG 948, medical | 27 | $25,515 | $5,039 | $6,915 | 0.80 |
| Other factors influencing health statusMS-DRG 951, medical | 19 | $21,545 | $3,795 | $5,839 | 0.59 |
Multiple significant trauma24 discharges in 2 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other o.r. procedures for multiple significant trauma with MCCMS-DRG 957, surgical | 13 | $250,984 | $63,212 | $68,017 | 7.23 |
| Limb reattachment, hip and femur procedures for multiple significant traumaMS-DRG 956, surgical | 11 | $139,025 | $25,953 | $37,676 | 3.88 |
Mental diseases and disorders22 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Organic disturbances and intellectual disabilityMS-DRG 884, medical | 22 | $46,914 | $11,684 | $12,714 | 1.76 |
Alcohol and drug use16 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Alcohol, drug abuse or dependence without rehabilitation therapy without MCCMS-DRG 897, medical | 16 | $23,982 | $5,369 | $6,499 | 0.86 |
Eye15 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Other disorders of the eye without MCCMS-DRG 125, medical | 15 | $25,781 | $5,202 | $6,987 | 0.80 |
Ear, nose, mouth and throat13 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| DysequilibriumMS-DRG 149, medical | 13 | $23,563 | $4,480 | $6,385 | 0.74 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service (2024 data, released 2026-04-10), traditional Medicare only; CMS omits DRGs with fewer than 11 discharges. Estimated cost is average charges times the hospital's Medicare cost-to-charge ratio from the IPPS Impact File. Weights are the MS-DRG relative weights for the same year.
Outpatient services
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Level 1 Intraocular ProceduresAPC 5491 | 587 | 418 | $9,390 | $1,508 | $1,752 |
| Level 2 Urology and Related ServicesAPC 5372 | 481 | 257 | $3,228 | $443 | $502 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 369 | 354 | $10,298 | $1,038 | $1,220 |
| Level 1 Endovascular ProceduresAPC 5191 | 296 | 295 | $29,830 | $1,906 | $2,208 |
| Level 3 Urology and Related ServicesAPC 5373 | 293 | 230 | $8,988 | $1,289 | $1,516 |
| Level 2 Upper GI ProceduresAPC 5302 | 289 | 250 | $7,051 | $1,227 | $1,445 |
| Comprehensive Observation ServicesAPC 8011 | 247 | 234 | $14,362 | $1,705 | $2,090 |
| Level 1 Nerve ProceduresAPC 5431 | 238 | 208 | $10,099 | $1,235 | $1,407 |
| Level 2 Intraocular ProceduresAPC 5492 | 234 | 192 | $17,519 | $2,686 | $3,116 |
| Level 4 Urology and Related ServicesAPC 5374 | 224 | 180 | $13,129 | $2,252 | $2,629 |
| Level 3 Vascular ProceduresAPC 5183 | 219 | 207 | $10,864 | $1,997 | $2,405 |
| Level 5 Urology and Related ServicesAPC 5375 | 189 | 170 | $24,612 | $3,312 | $3,918 |
| Level 3 Extraocular, Repair, and Plastic Eye ProceduresAPC 5503 | 180 | 175 | $11,404 | $1,547 | $1,780 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 143 | 126 | $15,939 | $1,867 | $2,141 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 132 | 129 | $37,403 | $4,483 | $5,339 |
| Level 3 Lower GI ProceduresAPC 5313 | 132 | 126 | $10,191 | $1,833 | $2,176 |
| Level 5 Musculoskeletal ProceduresAPC 5115 | 124 | 115 | $63,818 | $8,649 | $10,772 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 106 | 105 | $35,558 | $3,567 | $4,358 |
| Level 5 ENT ProceduresAPC 5165 | 92 | 90 | $39,121 | $3,859 | $4,436 |
| Level 3 Airway EndoscopyAPC 5153 | 89 | 84 | $6,886 | $1,071 | $1,264 |
| Level 4 Vascular ProceduresAPC 5184 | 88 | 83 | $29,032 | $3,503 | $3,946 |
| Level 3 Endovascular ProceduresAPC 5193 | 88 | 82 | $44,693 | $7,221 | $8,874 |
| Level 1 Breast/Lymphatic Surgery and Related ProceduresAPC 5091 | 78 | 73 | $23,417 | $2,541 | $2,930 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 78 | 74 | $18,126 | $2,017 | $2,373 |
| Level 4 Airway EndoscopyAPC 5154 | 78 | 76 | $17,221 | $2,399 | $2,833 |
| Level 3 Electrophysiologic ProceduresAPC 5213 | 74 | 73 | $73,843 | $17,942 | $21,117 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 72 | 69 | $8,601 | $1,012 | $1,196 |
| Level 2 Endovascular ProceduresAPC 5192 | 69 | 66 | $34,747 | $3,699 | $4,338 |
| Level 3 Upper GI ProceduresAPC 5303 | 69 | 65 | $12,010 | $2,514 | $2,888 |
| Level 2 Laparoscopy and Related ServicesAPC 5362 | 69 | 69 | $64,830 | $6,775 | $8,164 |
| Complex GI ProceduresAPC 5331 | 65 | 52 | $20,772 | $3,507 | $4,263 |
| Level 5 Neurostimulator and Related ProceduresAPC 5465 | 62 | 61 | $66,437 | $23,489 | $26,719 |
| Level 2 Vascular ProceduresAPC 5182 | 58 | 58 | $6,861 | $993 | $1,204 |
| Level 5 Airway EndoscopyAPC 5155 | 51 | 50 | $30,036 | $4,562 | $5,183 |
| Level 4 Neurostimulator and Related ProceduresAPC 5464 | 49 | 49 | $59,587 | $15,271 | $18,465 |
| Level 7 Radiation TherapyAPC 5627 | 49 | 48 | $40,094 | $5,191 | $6,121 |
| Level 2 Breast/Lymphatic Surgery and Related ProceduresAPC 5092 | 46 | 46 | $58,608 | $4,252 | $4,982 |
| Level 3 ENT ProceduresAPC 5163 | 40 | 30 | $5,857 | $892 | $1,106 |
| Level 2 Pacemaker and Similar ProceduresAPC 5222 | 39 | 38 | $36,310 | $5,367 | $6,514 |
| Level 3 Intraocular ProceduresAPC 5493 | 39 | 30 | $21,752 | $3,482 | $4,004 |
| Level 3 Pacemaker and Similar ProceduresAPC 5223 | 38 | 38 | $32,590 | $7,298 | $8,569 |
| Level 2 Neurostimulator and Related ProceduresAPC 5462 | 38 | 30 | $20,969 | $3,751 | $4,524 |
| Level 2 ICD and Similar ProceduresAPC 5232 | 37 | 37 | $64,121 | $25,811 | $29,375 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 31 | 27 | $13,550 | $2,234 | $2,636 |
| Level 4 Endovascular ProceduresAPC 5194 | 30 | 28 | $71,594 | $12,144 | $14,606 |
| Level 4 Gynecologic ProceduresAPC 5414 | 30 | 30 | $13,767 | $2,008 | $2,389 |
| Level 4 ENT ProceduresAPC 5164 | 29 | 29 | $19,134 | $2,146 | $2,217 |
| Level 6 Musculoskeletal ProceduresAPC 5116 | 27 | 26 | $79,729 | $13,413 | $15,763 |
| Cochlear Implant ProcedureAPC 5166 | 21 | 21 | $96,557 | $23,834 | $29,489 |
| Level 4 Pacemaker and Similar ProceduresAPC 5224 | 21 | 21 | $53,340 | $14,636 | $17,052 |
| Level 5 Gynecologic ProceduresAPC 5415 | 21 | 19 | $23,631 | $3,314 | $3,792 |
| Level 4 Extraocular, Repair, and Plastic Eye ProceduresAPC 5504 | 21 | 21 | $18,940 | $2,459 | $2,969 |
| Level 3 Neurostimulator and Related ProceduresAPC 5463 | 18 | 16 | $107,677 | $9,743 | $11,550 |
| Level 2 Nerve ProceduresAPC 5432 | 13 | 12 | $24,420 | $3,753 | $4,674 |
| Level 2 Electrophysiologic ProceduresAPC 5212 | 12 | 12 | $25,033 | $4,563 | $5,682 |
| Implantation of Drug Infusion DeviceAPC 5471 | 11 | 11 | $52,708 | $12,055 | $14,829 |
Source: CMS Medicare Outpatient Hospitals by Provider and Service (2024 data, released 2026-06-24), comprehensive APCs for traditional Medicare; CMS omits services with fewer than 11 claims. The US average weights every hospital by its services.